Individual
APRIL A THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1325 NE 7TH ST, GRANTS PASS, OR 97526-1358
(541) 460-5331
Mailing address
3265 HILLCREST PARK DR, MEDFORD, OR 97504-7657
(541) 210-8721
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
51464
CA
363A00000X
Physician Assistant
PA10004813
OR
363A00000X
Physician Assistant
Primary
PA198758
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195994
LABOR & INDUSTRY
WA
01
—
1366469074
MEDICAL
CA
05
—
8428922
—
WA
Enumeration date
07/17/2006
Last updated
05/12/2021
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